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EXECUTIVE SUMMARY

Missouri Department of Mental Health
1706 E. Elm Street
Conference Room B
Jefferson City, MO 65102

Mental Health Commission Minutes
October 12, 2006

Call to Order	John Constantino, Chair, called the meeting of the Missouri Mental Health Commission to order at 9:05 a.m. on Thursday, October 12, 2006. The meeting was held at the Department of Mental Health, 1706 E. Elm Street, Conference Room B, Jefferson City.
Introductions Approval of Minutes	Introductions were made. Phillip McClendon made a motion to approve the Mental Health Commission minutes for August 17 and September 14, 2006. Mary Lou Bussabarger seconded the motion and the minutes were approved.
Open Discussion	John Constantino referred to the Mental Health Commission minutes for August 17, 2006 and the presentation by Joe Parks regarding a request from the St. Louis Post Dispatch on DMH research projects. Joe shared that staff would prepare a spreadsheet with the number of projects that are currently open and will make it available for review. John referred to the September 14, 2006 Mental Health Commission minutes where discussion was held on the retention of qualified physicians for mental health and the current scoring system for Missouri. In response, Joe reported that the National Services Corp (NSC) handles eligibility differently than J-1 Visa's. For a J-1 Visa to serve their obligation to remain in the country they must be in a mental health manpower shortage area. National Service Corp participants must be in a mental health service area that has a particular score and in many cases the score is lower than the general score for a J-1 Visa. They also must work at a designated facility, which can be a prison, but if it is a hospital it must have an ambulatory component. Additional actions by Joe include 1) a survey with other state level mental health departments to see how they have handled the situation; 2) the loophole that indicates you can be designated if your acknowledges have a specific attribute. Joe is partnering with an APA lobbyist to review the loophole history. John inquired whether there were any budget updates or changes in the ranking order. There have been no changes. Mary Lou Bussabarger reported receiving newsletters for many years from Pathways to Promise, Interfaith Ministries and Prolonged Mental Illness. The newsletter is an interfaith technical assistance and resource which offers liturgical and educational materials, program models, and networking information to promote a caring ministry with people with mental illness and their families. These resources are used by people at all levels of faith group structures from local congregation to regional and national staff. Mary Lou praised the organization for their materials that can be shared through church bulletins and other resources. Phillip McClendon reported an audit was done on Joplin Regional Center by the State Auditor. Appropriate corrective actions will be implemented in the areas discussed in the report. Phillip expressed gratitude to the centers' interim director and staff, and he thanked Bob Bax for his leadership in handling the media.
DMH Director Selection Process	George Gladis presented an update on the Department of Mental Health Director Selection Process. Stuart Meyers of the Meyers Group will be meeting with members during the Closed Executive Session.
Director's Update	Ron Dittemore recognized Joe Parks, Medical Director on receipt of an award from the American Psychiatric Association. Psychiatric Services, Bronze Achievement Award Presented October 5, 2006 Behavioral Pharmacy Management Program Missouri Mental Health Medicaid Pharmacy Partnership Project In recognition of a groundbreaking program that continuously monitors statewide Medicaid pharmacy data and provides feedback to prescribers, encouraging then to modify their prescribing patterns to achieve best-practice standards. Ron reported that the 2006 Governor’s Award for Quality and Productivity was held October 13th. John Hanauer, an employee with DMH - Information Technology that is now part of the Office of Administration was a team member which included the Office of Administration, Office of State Court Administrators and the Office of the Secretary of State. The Active Director Team received the Technology in Government Award for the development of an active directory tool of information technology services used to manage the thousands of computers on the state network. Ron and Mark Stringer reported that the Lt. Governor’s Mental Health Task Force met on Wednesday, October 11th. Public hearings around the state have been completed and the process of formulating final recommendations is underway. The Task Force has received its early draft report which includes a summary of public testimony; draft recommendations and other department recommendations will be added. A final report will be completed by the first of December then submitted to the Governor. Ron acknowledged Eric Feltner, Deputy Lt. Governor who has provided the group with excellent leadership and guidance. Felix Vincenz reported that a group has convened to review the concept of employee misconduct as it relates to Class II Neglect. In a draft five categories of employee misconduct have been proposed and the group will look to track those by category and track the dispositions that result from them. A report will be presented at a future meeting. Patrick Murphy reported various recruitment methods to reach markets of labor pools to fill vacant positions across the state at habilitation centers. Marshall Habilitation Center held a job fair resulting in some success in hiring. Contract employees have been identified, 10 have agreed to work at Marshall and 5 have agreed to work at Higginsville. A Poplar Bluff furniture plant is closing and will host a job fair and department staff will work with their Human Resource Officer and plans to attend the event. The shortage at Marshall is at 52 DA I positions and 18 DA II positions; Higginsville is at 25 positions. Rhonda Haake presented an update on CIMOR. The past year was spent preparing CIMOR data, putting in organizational foundations and information to support the consumers and services components. In September 2006 there were 800,000 consumer records and episode records converted from CTRAC into CIMOR. During the month of September users continued to enter new consumer information into CTRAC and the first week of October additional conversions were done. Special Releases were done on October 5 and 11 to fix bugs and improve the speed of critical pages. The request to add to the home page a reminder to users that everything they do is audited and tracked. 18,426 services have been processed Approximately 11,000 Medicaid claims have been created and are in processing steps Approximately 1,000 SAM 2 invoices have been created The CIMOR Statistics for October 3 – 11 include the number of: Users Accessing CIMOR Per Day Page “Hits” Per Day Average “Hits” Per Hour – from 7 a.m. – 7 p.m. Help Desk Requests Per Day Average Help Desk Requests Per Hour – from 7 a.m. – 6 p.m. Help Desk Tickets Closed Per Day Help Desk Staffing Security Requests Processed Per Day Clive presented an update on DMH Safety Indicators (DRAFT). The outlined the following: Substantiated Abuse/Neglect Investigations by Facility (FY 06) Habilitation Center Statewide Scorecard Measures for 4th Quarter FY 2006 CPS Facility Statewide Scorecard Measures for 4th Quarter FY 2006 Regional Center Statewide Scorecard measures for 4th Quarter FY 2006
Medicaid Update	Joe Parks, Medical Director, presented an overview of the Professional Research Committee. By statute the department is required to do what it can to support, facilitate and do research to benefit the people it serves. The department is required to monitor the research to assure that it is a reasonable likely value and the methods are adequate and that no one is harmed and all are adequately informed. The Professional Research Committee is defined in statute and reviews all the prospective or bio-medical research. It does not have to review the retrospect or program evaluation studies. Currently there are 25 projects open; some are prospective most are bio-medical. the spread sheet outline the project by date, when they were open; the estimated end date; where we are in the data collection analysis or report preparations; there are other reports of studies that are closed and reported out. Joe presented an update on the Behavioral Pharmacy management system (BPMS) in a power point presentation that outlined Getting at Cost via Quality. The BPMS purpose is to improve the pharmacy prescribing practices.
Network of Care	Monica Hoy and Kathy Sterbenz presented a web-cast overview of the "my folder" component of Network of Care. KSDK Channel 5 News St. Louis highlighted the web site during their morning program. MRDD and CPS coordinated a presentation and booth at the Missouri State Library Association. 500 Librarians from across the state attended the conference. The Department's Missouri Library Assistive Technology Act Grant helped to provide training persons with disabilities and their families. Future plans include presenting information about the Network of Care at the NAMI Conference, Spring Training Institutes and Mental Health Awareness Day. Launches are being planned in St. Louis, Jackson County and Springfield. Over 3,486 individuals have been trained in the MRDD system. An MRDD training evaluation and web page survey form have been developed and are being used consistently statewide. Information will be used to improve the training and to expand and improve web page content. MRDD staff presented the Network of Care at the Missouri Counsel of Administrators of Special Education Conference which had 1,000 attendees. A presentation for 809 People First Members was held in August 2006. Attendees were enthusiastic about the Advocator and the ability to create local chapter web pages for fee.
Proposed Rules Regarding RCF	Dora Cole, Interim Division Director, Comprehensive Psychiatric Services, presented an update on Senate Bill 616 - residential care facility/assisted living. The bill passed this year and its intent is to change the name of residential care facilities to assisted living and there be no more designation of I or II. The department is working with DHS to reach an appropriate comfort level for all on this issue. A proposed rule has been filed with comments received for 30 days.
Autism	Paula Baker, CEO of Ozark Center made an Autism Speaks presentation. Comments included the benefits of developing an autism registry along with the use of the infrastructure of Network of Care. Bernie Simons, Division Director, MRDD provided additional comments regarding autism and announced that the University of Missouri-Columbia, Thompson Center for Autism and Neurodevelopmental Disorders joins Baltimore's Kennedy Krieger Institute in the development of a state level model for the Institute's national autism registry, the Interactive Autism Network (IAN). The IAN project is a web-based research initiative with both a research and community focus. The research arm will provide a secure, online national registry where parents of children with autism and the nation's qualified researchers can connect and work together to learn more about the causes and treatments for the disorders. The online IAN community will provide a home for those that want to learn about the latest developments in autism research and care, share ideas and support other family similar challenges.
Division and Section Updates	Patty Henry, Budget Director, reported that the FY 07 and FY 08 Supplemental Budgets were submitted prior to the October 1 deadline. Next steps include a meeting with Budget and Planning and Governor's Office staff to discuss budget items in more detail, and then prepare for the Governor's Recommendations that will be announced in January 2007. Jan Heckemeyer, Deputy Director of Administration reported that the Capital Improvements budget process is behind schedule. The department awaits Facilities Management's list of projects based on their assessments. Next steps would be to rank and prioritize maintenance and repair projects as well as any new construction requests. Once the appropriate meetings and rankings have been completed the information will be forwarded to Commissioners via email for their feedback. Michael Couty, Division Director, Alcohol and Drug Abuse reported that Senator Michael Gibbons has hosted roundtable discussions to examine the success of the new law, SB 402, in helping curb underage drinking, as well as to discuss the ease of its implementation and if there are further steps that may be taken. Roundtable participants include: Regional Leaders-Division of Liquor Control; Department of Mental Health; Law Enforcement; Prosecutors; School Representative and Community Advocates. There have already been two meetings with future meeting as follows: October 11 - Troop F, Jefferson City October 16 - Troop C, St. Louis October 18 - Troop E, Poplar Bluff November 13 - Troop B, Macon November 14 - Troop I, Rolla November 14 - Troop G, Willow Springs November 28 - Troop A, Lee's Summit November 28 - Troop H, St. Joseph Dora Cole, Interim Division Director, Comprehensive Psychiatric Services, introduced Joe Yancey, Interim Deputy for the division. Bernie Simons, Division director, Mental Retardation Developmental Disabilities reported on the following: Systems Transformation Grant - Steering Committee with 40 members and guests met to review and discuss progress on activities toward goals in the strategic plan for the grant. Self-Advocates and Families for Excellence (SAFE) is a statewide volunteer organization consisting of people with developmental disabilities/self-advocates and family members of people with disabilities. Letters have been sent to SB 40's and the regional centers and training continues across the state through November. The SAFE web site is up and running, information regarding the SAFE process, training, brochure and a volunteer application can be found on the DMH web page at http://www.dmh.mo.gov/mrdd/progs/SAFE/mrddsafe.htm. It was suggested that both the MRDD web page and Network of Care have a centrally located page where a complaint, issue or problem can be shared. Felix Vincenz, Interim Director, Facility Operations reported that Dr. Jim Finch, Superintendent at Bellefontaine Habilitation Center and St. Louis Developmental Disabilities Treatment Center has resigned effective November 9, 2006. Recruitment to fill his position is underway. Survey activity on behalf of the Centers for Medicare and Medicaid Services - Title XIX, have occurred at the following facilities: Bellefontaine Habilitation Center Marshall Habilitation Center Southeast Missouri Residential Services - Poplar Bluff St. Louis DDTC Corrective action plans have been submitted in all cases where deficiencies have been identified, with revisits confirming that progress is being made. No conditions of participation have been cited and certification by CMS continues. Diane McFarland, Coordinator/Chair, Transformation Grant reported transitioning into another office location along with the selection of staff. An Executive Order from the Governor is anticipated and will include the appointments to be made to the Mental Health Transformation Group. The first meeting for the working group is being planned for November. There was discussion regarding the Children's Data Warehouse. Jan Heckemeyer shared that a meeting is planned with participants from Social Services, Mental Health and OA/ITSD to discuss funding form the next phase. At a future meeting a Children's Data Warehouse update will be presented.
Public Comments	Diane Mack, parent advocate, presented testimony regarding SPOE. Tim Swinfard, President, Missouri Coalition of Community Mental Health Centers extended congratulations to division leadership and staff for their diligent support to CIMOR - live. He also shared that the consumer groups have expressed their appreciation to the Commission for the opportunity to have input in the budget process. The Department received 273 letters from the advocacy community regarding the budget.
Executive Session	Beth Viviano made a motion that the Mental Health Commission go into Closed Executive Session in accordance with Section 610.021 (3), RSMo, Personnel. Mary Lou Bussabarger seconded and the motion passed.
Adjourn	The Mental Health Commission adjourned at 12:30 p.m. Approved January 11, 2007 _________________________________________________ John Constantino, Chair